Basic Information
| Provider Information | |||||||||
| NPI: | 1497918536 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | NW PAIN MANAGEMENT AND REHABILITATION ASSOCIATES, INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | DEPT 1008 | ||||||||
| Address2: | PO BOX 34936 | ||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 98124 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2064392988 | ||||||||
| FaxNumber: | 2064313939 | ||||||||
| Practice Location | |||||||||
| Address1: | 16110 8TH AVE SW | ||||||||
| Address2: | SUITE B-1A | ||||||||
| City: | BURIEN | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981662962 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2065186081 | ||||||||
| FaxNumber: | 2065186084 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/09/2008 | ||||||||
| LastUpdateDate: | 08/04/2008 | ||||||||
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| AuthorizedOfficialLastName: | ZHONG | ||||||||
| AuthorizedOfficialFirstName: | MICHELLE | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 2065186081 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208100000X | MD00039410 | WA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation |
No ID Information.